Organization
ELLINGSEN -PAXTON DDS PS
Active
Organization
ELLINGSEN -PAXTON DDS PS
Active
Other names
Ellingsen Paxton Johnson Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD C ELLINGSEN DDS (PRESIDENT)
(509) 926-0570
Entity
Organization
Contact information
Practice address
12109 E BROADWAY AVE STE B, SPOKANE VALLEY, WA 99206-6133
(509) 926-0570
(509) 921-9163
Mailing address
12109 E BROADWAY AVE STE B, SPOKANE VALLEY, WA 99206-6133
(509) 926-0570
(509) 921-9163
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
60083394
WA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DE00005607
WA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DE00006352
WA
Other
Enumeration date
10/25/2006
Last updated
11/19/2009
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